Orthopaedic Connection

What Is Separation?

By Thomas J. Haverbush, M.D. Orthopaedic Surgeon

Transforming patient information into patient understanding.

Shoulder separation is completely different from shoulder dislocation. Most of my patients get the two confused. If I can, I will try to demystify the two conditions.

Mechanism There is a sharp blow to the tip of the shoulder when you fall on your shoulder (not the or hand). It happens sometimes when a quarterback is tackled in the backfield (sacked). The collar bone separates or comes loose from its attachment to the . tear, the pops up under the skin and you now have a separated shoulder. Ouch! It really hurts and looks awful.

The A-C The injury is to the so called A-C joint. Not to be confused with ACL (that is in the !). Not to be confused with dislocation – that is the ball coming out of the socket. Shoulder separation is the collar bone and shoulder blade coming apart on the very top of the shoulder.

Mild or Severe A shoulder separates because there is damage to ligaments holding the bones together. How severe the separation is depends on how badly the ligaments are torn.

Signs and Symptoms The symptoms can vary a lot.  Pain on top of the shoulder  May be able to see a bump. That is the clavicle sticking up.  Lifting the is very hard to do.  Shoulder feels best with the arm supported.

When To Call Me  If pain persists even though you do not see a bump  If you see a bump  Shoulder looks deformed  Can’t use the arm

Making the Diagnosis If on exam I suspect a shoulder separation, I will x-ray the shoulder while the patient holds a light weight. An x-ray of the uninjured shoulder might be taken as comparison. When the shoulder is separated the collar bone pops up and is higher than on the uninjured side.

How I Treat It

 If the separation is mild a sling will be worn for a few days until the pain goes away.  Ice reduces swelling and pain.  Advil or similar is usually enough for pain.  As swelling decreases the collar bone may settle back into place.  Exercise will be needed to restore motion and strength.  It may take a month to return to sports.

Major (Severe) Separation If there is major ligament damage, surgery is usually required to repair the shoulder. There are several ways this can be done. A special sling will be needed for at least a month followed by several weeks of physical therapy.

My patients put their trust in me and what I do improves the quality of their lives.

Gratiot County Herald Archive and Office Website I hope what you have read has raised questions. No problem! Please log onto www.orthopodsurgeon.com. It has a huge amount of musculoskeletal information in the Website and the Archive of all previous GCH articles. Check it out and be amazed what you can learn. Good health. Good life. All the best to you. Be well.

Dr. Haverbush